Healthcare Provider Details

I. General information

NPI: 1194138313
Provider Name (Legal Business Name): WENDE GELB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 NW 12TH AVE #6006
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1161 NW 12TH AVE #6006
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6042
  • Fax: 305-545-6018
Mailing address:
  • Phone: 305-585-6042
  • Fax: 305-545-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME144585
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN 19751
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number287963
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: